Provider Demographics
NPI:1760281984
Name:PIN, RENE VICHARA (PA-C)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:VICHARA
Last Name:PIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3719 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-4828
Mailing Address - Country:US
Mailing Address - Phone:317-515-0131
Mailing Address - Fax:765-293-8485
Practice Address - Street 1:3719 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4828
Practice Address - Country:US
Practice Address - Phone:765-293-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant